Rising pressure: hospital emergency departments as barometers of the health care system.

Ann S O'Malley, Anneliese M Gerland, Hoangmai H Pham, Robert A Berenson
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Abstract

Pressures--ranging from persuading specialists to provide on-call coverage to dealing with growing numbers of patients with serious mental illness--are building in already-crowded hospital emergency departments (EDs) across the country, according to findings from the Center for Studying Health System Change's (HSC) 2005 site visits to 12 nationally representative communities. As the number of ED visits rises significantly faster than population growth, many hospitals are expanding emergency department capacity. At the same time, hospitals face an ongoing nursing shortage, contributing to tight inpatient capacity that in turn hinders admitting ED patients. In their role as hospitals' "front door" for attracting insured inpatient admissions, emergency departments also increasingly are expected to help hospitals compete for insured patients while still meeting obligations to provide emergency care to all-comers under federal law. Failure to address these growing pressures may compromise access to emergency care for patients and spur already rapidly rising health care costs.

压力上升:医院急诊科成为医疗保健系统的晴雨表。
卫生系统改革研究中心(HSC) 2005年对12个具有全国代表性的社区进行了实地考察,结果发现,从说服专家提供随叫随到处理越来越多的严重精神疾病患者,压力正在全国各地已经拥挤的医院急诊科(EDs)中增加。由于急诊科就诊人数的增长明显快于人口的增长,许多医院都在扩大急诊科的能力。与此同时,医院面临着持续的护理短缺,导致住院病人能力紧张,反过来又阻碍了急诊科病人的入院。作为医院吸引有保险住院病人的“前门”,急诊科也越来越多地被期望帮助医院争夺有保险的病人,同时仍然履行联邦法律规定的为所有来看病的人提供紧急护理的义务。如果不能解决这些日益增长的压力,可能会危及患者获得紧急护理的机会,并刺激本已迅速上升的卫生保健费用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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